Multiple Sclerosis and Vision: Are You Ready for the Challenge?

“Nothing is so painful to the human mind as a great and sudden change.” – Mary Shelley, Frankenstein

Every single day, those living with multiple sclerosis wage a war on two fronts. Symptoms come and go, often with no pattern or predictability. We fight the symptoms of our illness and we battle against the unknown danger lurking within the next relapse. And we know there is going to be another relapse. What we don’t know is where, when and how big!

Multiple sclerosis and vision changes go hand in hand and can be particularly difficult to accept. We can be hit with a sudden loss of vision or it can be a gradual decline. Either way, a little planning can go a long way in allaying some of our fears.

Optic Neuritis: What a Pain in the Eye!

Optic neuritis (ON) is inflammation of the optic nerve, which transmits signals from the retina to the brain. It typically affects one eye at a time; take comfort in small things. Early in the course of my MS, I experienced several painful bouts of optic neuritis, with a stabbing and burning feeling located just behind my eyeball. It can distract you from doing anything else and starts to drive you crazy if it goes on for a period of time. Frequently my ON was accompanied by a graying of color vision in the effected eye. Fortunately, I did not experience a significant loss of visual acuity, as it is common in others with optic neuritis.

My neurologist prescribed an IV dose of steroids during painful bouts and I responded very well to these treatments. However, the five rounds of IV steroids I received over 18 months came with some pretty tough side effects, including massive weight gain. Often, neurologists will not prescribe treatment, since most cases of ON will improve on their own within 4 to 12 weeks. I say improve because each bout of optic neuritis often leaves a “gift” of residual damage that will not heal. Over time, these residual gifts start to accumulate and cause the long-lasting visual damage so common with MS. Each case of ON needs to be reviewed by your neurologist to determine the best course of action.

Team Work

“Alone we can do so little; together we can do so much.” – Helen Keller

Diplopia (double vision) is the experience of seeing two of everything. Typically, it is caused by either weakening or lack of coordination of eye muscles. Some people have acute attacks of double vision and are advised to patch one eye until the symptoms resolve. Because I have been diagnosed with a progressive form of MS, my experience with double vision has been a slow but steady process of building from the point of a major annoyance to an incapacitating change in my ability to read, write and drive. When watching TV, I had to get used to seeing two of everything on the screen. The fun part was when looking across a room, I would play a guessing game to choose the real image from the imposter. The images were mainly side by side, but some people see top over bottom images.

The loss of coordination between the eyes can also lead to small, oscillating movements of the eye, called “saccades.” The result is a blurring, jiggling, or shimmering vision. I suffer terribly from these visual distortions. Tracking of objects in motion can make me feel off balance, dizzy and even nauseous. It is particularly difficult to eat when there is too much motion or visual distractions.

Reading normal text is also tough because of the repetitive tracking, from one line to the next, makes the text appear to be jiggling. My symptoms did not resolve on their own. My neuro-ophthalmologist prescribed bi-focal eyeglasses with special prisms added. These prisms help to bend the light in a way that compensates for the misalignment of my eye muscles. These glasses are very helpful in restoring my ability read, write, and drive.

Retinal Changes: Now I see the light, and it’s too bright

An emerging area of MS research concerns changes to the retina. More specifically, MS is now believed to be responsible for retinal nerve fiber layer (RNFL) thinning. These changes can be measured by a painless, non-invasive, test called optical coherence tomography (OCT). OCT is very similar to ultrasound imaging, except that it uses light instead of sound. In fact, OCT may soon be one of the primary tests used to diagnose MS.

My neuro-opthomogisits have performed several OCT tests on my eyes and explained that I am suffering a RNFL thinning of the central part of my retina. This is often a very slow process; I again take comfort in small things. My symptoms are extreme sensitivity to bright light, a sharp reduction in color vision, a gradual loss of visual acuity and difficulty seeing at night. These are all classic symptoms RNFL thinning. They suggested that I add an amber tint to my prism glasses, and it has greatly reduced the harshness of light glare and eye strain.

Small Fixes, Big Wins: The Pirate Look

“Improvise, Adapt and Overcome” – USMC, unofficial slogan

As our symptoms change so quickly, we must learn and relearn ways to accommodate our new challenges. I have carried an eye patch with me for years and have found it useful on many occasions when optic neuritis, double vision or saccades are troublesome (or if you enjoy the pirate look). While eating, we try to minimize visual distractions (a big thank you to my family). When dining at restaurant, we request to be seated facing a wall. I have also been known to eat with my eyes closed, especially at holiday dinners. Wearing a hat, even indoors, is very helpful in reducing the amount of light reaching my eyes.

I can only read a book printed in the NAVH (National Association for the Visually Handicapped) format, since it is not only in a large font, but has margins and line spacing’s that are agreeable with visual disabilities. The Kindle and Nook e-readers allow users to adjust settings, yielding text similar to NAVH format. These e-readers do not have the often harsh LCD screen back-lighting found on many laptops and tablets. Contrast is very important in seeing items clearly, as I use a yellow font against an all-black background when composing my blogs on my computer. I write with a bold (1.6mm) black pen on a yellow legal pad.

These changes have made my life easier and more productive.

Have you experienced MS visual disturbances? How have you adapted to these challenges? We would really like to know.

Get the latest health updates

Thanks for signing up!

Oops!

A system error was encountered. Please try again later.

Follow us on your favorite social network!

ABOUT THE AUTHOR

Brad and Robynn Mann

Brad and Robynn Mann are long time residents of NJ. Brad grew up in Long Island NY but moved to the Garden State to be closer to Robynn. They have been married over 18 years and they have 4 amazing children,...read more

SEARCH ALL COLUMNS

This site complies with the HONcode standard for trustworthy health information: verify here.

Advertising Notice

This Site and third parties who place advertisements on this Site may collect and use information about
your visits to this Site and other websites in order to provide advertisements about goods and services of
interest to you. If you would like to obtain more information about these advertising practices and to make
choices about online behavioral advertising, please click here.